solid organ transplants Flashcards
what is the process of a SOT
assessment
waiting list and exclusion criteria
- blood group
- HLA compatibility
what are the aims of SOT
increase life expectancy
increased QOL
what are the issues associated with SOT and how are they mitigated
recipient immune response - immunosuppression
what are the risks of immunosuppression treatment in SOT patients
side effects
infections
malignancy
post transport lymphoproliferative disease
what is a xenograft
a graft between 2 different species - likely to reject
what is an autograft
from one part of the same body to another
what is an isograft
grafts between genetically identical individuals
what is an allograft
graft between members of the same species
what antigens are responsible for rejection in SOT
histocompatibility antigens - human leukocyte antigen and MHCI and II
what immune responses are involved in SOT rejection
adaptive and innate - T cells are central - clonal expansion and differentiate - to harm the graft
what are the steps to the immune response in SOT rejection
- t cell recognition
- signal 1 - t cell and MHC
- signal 2 - co stim between t cell and APC (CD28 and B7 1/2)
- activates 3 signal pathways
- calcium-calcineurin
- mitogen activated pathway
- PKC - kappa B - transcription factor activation and T cell activation
why is HLA compatibility important in SOT
can minimise and control hosts immune response but may not always be possible
what are the benefits to HLA compatibility in SOT
better function
fewer rejection episodes
longer graft survival
possibility to reduce immunosuppression
